Tuesday, 29 March 2005

When healthy people imagine the quality of life they would have with a chronic illness, their estimates are much more negative than reports from people who actually have a chronic illness. This suggests people tend to be much better able to cope with illness than we might think. But it could also be due to responses biases - for example, ill people might overestimate their mood for the benefit of their carers, or they might overly focus on positive aspects of their life as a coping strategy.

Jason Riis (University of Michigan) and colleagues sought to overcome this problem by asking patients and healthy controls, for one week, to rate their mood when prompted every 90 minutes or so by a pocket computer. This procedure, known as 'ecological momentary assessment', is thought to minimise the possible influence of biased recall. The 49 patients had end-stage renal disease and received a 3-hour-long hemodialysis treatment three times per week.

The average mood ratings made on the pocket computer were equally positive among both the patients and healthy controls. Yet when interviewed, the healthy participants predicted their mood would be negative most of them time if they had a chronic kidney illness. And the patients predicted their mood would be much more positive if they'd never had a kidney illness. That is, both groups of participants appeared to underestimate the resilience of people's mood to illness.

"For most of us, it would take a lot more than we think to make us permanently miserable", the authors said. And this has important implications for policy-makers: "...consideration of the moods experienced by patients may influence policy priorities between serious conditions such as, for example, paraplegia and depression."
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